Gastro-oesophageal Reflux Disease (GORD)
is a digestive disease characterised by chronic acid reflux, which occurs when stomach acid flows back into the oesophagus, which can result in inflammation and damage to distal oesophagus and/or stomach.
Causes of GORD may include transient lower esophageal sphincter (LES/LOS) relaxation or decreased LES tone, impaired esophageal clearance, delayed gastric emptying and decreased salivation.
Dietary management of GORD
Diet plays a key role in the management of GORD. Some interventions that may be considered in the management can include:
Change in dietary and lifestyle habits
Limit gut irritants i.e caffeine, alcohol, fried food, citrus fruits, peppermint, chocolate, chilli, tomato products
Elimination Diet (Low FODMAP diet)
The Low FODMAP Diet
The low FODMAP diet is an evidence based dietary strategy to successfully manage functional upper gastrointestinal symptoms including functional dyspepsia (indigestion) and lower gastrointestinal symptoms (e.g those present in IBS). Pressure or symptoms from one area of the GI track can influence and exacerbate the other.
FODMAP is an acronym for Fermentable Oligo-, Di, Mono-saccharides And Polyols. It is considered to be a second-line dietary strategy after assessment and management of dietary and lifestyle factors that may contribute to symptoms.
The low FODMAP diet involves collective restriction of a group of short-chain carbohydrates that have been shown to increase small intestinal water volume and be rapidly fermented in the large intestine, leading to increased gas (e.g. hydrogen) production and gastrointestinal symptoms (i.e. pain, bloating, distension, flatulence, nausea and altered bowel motility).
The low FODMAPs diet is a dietitian-taught program to ensure nutritional intake adequacy despite food restrictions. The long-term restriction of FODMAPs is not recommended. Structured reintroduction of FODMAPs is recommended after two to six weeks to identify which FODMAPs you are sensitive to, your level of tolerance to each individual high FODMAP foods, and optimise food variety and self-management long term.
Gastrointestinal System - Irritable Bowel Syndrome Background. 2018. PEN
Drossman DA, Hasler WL. Rome IV-Functional GI Disorders: Disorders of gut-brain interaction. Gastroenterology. 2016 May;150(6):1257-61. doi: 10.1053/j.gastro.2016.03.035. Citation available from: https://www.ncbi.nlm.nih.gov/pubmed/27147121
National Institute for Health and Clinical Excellence. Irritable bowel syndrome in adults. Diagnosis and management of irritable bowel syndrome in primary care. London (UK): National Institute for Health and Clinical Excellence. Clinical guideline 61 Update 2015. Available from: http://www.nice.org.uk/Guidance/CG61
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